Ennoble Hc Nj PC
NPI 1306500764ActiveOrganization· Family Medicine, Geriatric Medicine· Hackensack, NJ
Family Medicine, Geriatric Medicine in Hackensack, New Jersey, registered in NPPES in October 2021. The authorized official on file is Kushabhadra Das, Ceo. Enrolled in Medicare as part b supplier - clinic/group practice and part b supplier - clinic/group practice.
Overview
| NPI | 1306500764 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 22, 2021 |
| Last updated in NPPES | Nov 8, 2022 |
| Certified by provider | Nov 8, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine, Geriatric Medicine Primary | 207QG0300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AZ); Part B Supplier - Clinic/Group Practice (DE); Part B Supplier - Clinic/Group Practice (MA); Part B Supplier - Clinic/Group Practice (NJ); Part B Supplier - Clinic/Group Practice (OK); Part B Supplier - Clinic/Group Practice (PA); Part B Supplier - Clinic/Group Practice (SC) |
|---|
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